Individual provider Active NPI

Andrea Marie Malon, M.D.

  • Surgical Oncology Physician
  • Middletown, CT
National Provider Identifier
1306825609
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
033184 Issued in CT
Practice address
540 Saybrook Rd Ste 100
Middletown, CT 06457-4760
Phone
(860) 358-2850
Fax
(860) 358-8698
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 033184 CT
Colon & Rectal Surgery Physician 208C00000X 033184 CT
Surgery Physician 208600000X 21347 CT
Surgical Oncology Physician 2086X0206X 033184 CT Primary

Addresses

Primary practice location

540 Saybrook Rd Ste 100
Middletown, CT 06457-4760

Mailing address

862 Arbutus St
Middletown, CT 06457-5177
Phone (860) 346-2608

Other identifiers 1

IdentifierTypeStateIssuer
001331842MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101013000494 CT Practitioner - General Surgery 5597826487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Icahn School of Medicine at Mount Sinai, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MHS Primary Care, Inc.Group PAC ID 4082507371, 180 clinicians

Practice addresses (Care Compare)

14 Jones Hollow Rd
Suite 2
Marlborough, CT 06447-1448
Phone (860) 358-2850

250 Flat Rock PL
Westbrook, CT 06498-3585
Phone (860) 358-3640

28 Crescent St
Middletown, CT 06457-3654

540 Saybrook Rd
Middletown, CT 06457-4711
Phone (860) 358-5120

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21347CTMDSurgery Physician
033184CTMDSurgical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MHS Primary Care Inc CurrentSince Oct 1, 2015 Accepting new patients
MHS Primary Care, Inc CurrentSince Oct 1, 2015 Accepting new patients

Locations

14 Jones Hollow Rd
Ste 2
Marlborough, CT 06447

540 Saybrook Rd
Ste 100B
Middletown, CT 06457
Phone (860) 347-6683

520 Saybrook Rd
Middletown, CT 06457
Phone (860) 346-2608

520 Saybrook Rd
Ste N100
Middletown, CT 06457
Phone (860) 344-1801

520 Saybrook Rd
Ste S100
Middletown, CT 06457
Phone (860) 346-2608

28 Crescent St
Middletown, CT 06457
Phone (860) 358-6000

Interoperability endpoints

  • Direct secure messaging: amalon14808@middlesexhealthprd.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1306825609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "862 ARBUTUS ST",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064575177",
            "telephone_number": "860-346-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 SAYBROOK RD STE 100",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574760",
            "telephone_number": "860-358-2850",
            "fax_number": "860-358-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALON",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CT",
            "license": "033184",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CT",
            "license": "033184",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "21347",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "CT",
            "license": "033184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001331842",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.